AYUSHDHARA ISSN: 2393-9583 (P)/ 2393-9591 (O) An International Journal of Research in AYUSH and Allied Systems

Review Article

NEED OF INTEGRATED APPROACH AGAINST CANCER TO IMPROVE QUALITY OF LIFE INSIGHT OF AYURVEDA Kiran Tawalare1*, Ganesh Hedaoo2, Snehvibha Mishra3, Ravindra Dhimdhime4, Gopal Sharma5, Kalpana Tawalare6 *1Assistant Professor, 2P.G. Student, 3Associate Professor, Department of Kriya Sharir, Shri Ayurved College, Nagpur. 4Professor, Department of Kriya Sharir, Govt. Ayurved College, Osmanabad. 5Professor, Department of Rachana Sharir, Govt. Ayurved College, Nagpur. 6Assistant Professor, Dept. of Rachana Sharir, Shri Ayurved College, Nagpur.

KEYWORDS: Ayurveda, Arbuda, ABSTRACT Cancer, Vihar, Granthi, Satva, Being leading cause of death in economically developed countries and second Yoga. leading cause of death in developing countries cancer become giant problem. In India, 155863 new cases will be detected by 2015 and death would be 75957 hence, there is an increase in incidence as well as mortality rate. Many efforts are taken to control the disease by scientist and health organization, but still, it is

spreading swiftly. Available treatment of cancer can prolong the survival of patient, but may cause severe adverse effects and obliterated the quality of life. Even experts believe that role of chemotherapy is complex issue at the end of life. *Address for correspondence Thus ray of hope turns toward palliative care to treat the cancer. With an aim to Dr. Kiran Tawalare increase the life quality of the cancer patient, author consulted the classic text of Assistant Professor, Ayurveda. It was found that the disease resembling with cancer codified in the Department of Kriya Sharir, Shri classic text of Ayurveda in the form of Granthi and Arbuda with Shodhan Ayurved Mahavidyalaya, Nagpur (curative) and Shaman (palliative) treatment and regimen to follow Aahar, Vihar, Email: [email protected] Dincharya, Rutucharya, Sadvritta, Yoga, and Satvavajaya treatment. Integration of

Contact: 09226209022 modern and holistic method of treatment will definitely prove boon for cancer patient and will help them to enjoy meaningful life.

INTRODUCTION In India the international agency for research on combination, including surgery, chemotherapy and cancer estimated indirectly that about 635000 people radiation treatments. Sometime due to this treatment, died from cancer in 2008 representing about 8% of all patient are suffering from many side effects which are estimated global cancer death and 6% of all death in very dreadful than actual symptoms of cancer. In India.[1] Cancer is not just one disease, but a large group addition to these, many patients are offered Ayurveda of almost 100 diseases degrading patient slowly treatments either aimed at controlling the tumor or at physically mentally and economically, making their life improving the symptoms and quality of life of the patient. miserable. Two main characteristics of cancer are Classical Ayurveda literature has given ample uncontrolled growth of the cells in the human body and indication that cancer was known to ancient Ayurveda the ability of these cells to migrate from the original site physician. Cancer definitely is not a modern disease; and spread to distant sites. If the spread is not controlled, Aacharya described the cancer in the name of Arbuda cancer can result in death. Part of the problem is that the and Granthi. It is a disease with the involvement of three malignant cells are living in and invading normal tissue Doshas (Vata, Pitta, Kapha) and Mansa, Rakta, Medas around it. While some of these tumors can be fairly well dhatu as principal Dushyas. Ayurveda helps cancer circumscribed and isolated, some are quite invasive and patients to improve their quality of life and getting better spread throughout various parts of the body, making curative effect. Aggravated Doshas causing vitiation of their removal quite difficult. The goals of treatment for the muscle tissue produce muscular swelling, anywhere cancer are generally to reduce the amount of cancer cells in the body which is round, static, with mild pain, big in in the body, to zero ideally. However, this is often easier size, deep rooted, growing slowly and not ripening this said than done. Many of the efforts are being made to disease is called as Arbuda (~malignant tumor).[2] Vata control the disease by doctors, scientists, and health and other Doshas associated with Kapha, getting organizations but still cancer is spreading very fast. aggravated, vitiate the muscle, blood and fat tissue and In general, three major forms of cancer produce a round bulged and hard swelling is called as treatment have evolved; often times used in some Granthi (~benign tumor).[3] Aacharya Charaka AYUSHDHARA | November - December 2015 | Vol 2 | Issue 6 428 AYUSHDHARA, 2015;2(6):428-432 distinguishes Granthi from Arbuda by the presence of a  Infection due to prolonged bed rest and depression capsule.[4] According to certain thoughts among the of immune system by cytotoxic drugs and irradiation Ayurvedic physician, pathology of cancer can be by X- ray or radioactive isotopes used in treatment. correlated with the following disease Dustashotha,  Organ failure - tumor may destroy to much tissue Dustagranthi, Dustaviserpa, Dustanadivarana, that an organ cannot function, severe damage to vital Dustamansa pradosaj vikara, Pandu (anaemia), organs such as lungs, brain, liver and kidneys are Rakatajkrimi.[5] common cause of death. The object of Ayurveda is to protect health of the  Carcinomatosis - When there is wide spread healthy persons and to cure the disease of diseased metastatic disease associated with cachexia, severe [6] one. Ayurveda treatment plays an important role in physiological and biochemical disruption follows cancer. It is not only reducing symptoms but also causing death. improve quality of life. During chemotherapy and  Hemorrhage - This may occur when a tumor grows radiotherapy patients faced many side effects, principles into and ruptures the wall of a vein or artery, the of Ayurvedic treatment can help the patient to reduce most common sites are gastrointestinal tract, brain, side effect Hence, there is an urgent need to lungs and peritoneal cavity.[9] communicate precious holistic knowledge of Ayurveda to the scientific world. This will lead to create awareness Due to side effects of conventional cancer about palliative concept of Ayurveda in scientific therapy, the complementary and alternative medicine community. Ayurveda has the potential to become an has attracted the view of researcher and medical important arm in standard care of cancer treatment. The practitioners. Assessing above major side effects of ancient wisdom of Ayurveda needs to be explored in a chemotherapy are looked through an Ayurvedic scientific world. The doctors, Vaidyas, researchers, and perspective; it appears that they are symptoms of scientists have to work together to generate various level Raktadusti and manifestation of aggravated Pitta dosha. of evidence to improve the quality of life in cancer The compendia helps doctor and patient suffering from patients and make them peaceful while moving toward cancer to combat serious chemo-radio therapy related end. side effects through simple but effective science based Ayurveda remedies. These described treatments are Aims commonly available and these Ayurveda based solution -To state utility of palliative treatment in the patients of act as an important adjuvant to chemo-radio therapy and cancer. enhance the quality of life of cancer patients. -To assess the significance of integrated cancer Ayurveda can full fill the expectations of such treatment to improve quality of life. patients by adding years in their life and improve quality Materials And Methods of life. It is observed that patient take different decisions Classical texts of Ayurveda viz. Charaka Samhita, about chemotherapy near the end of life such treatment Sushruta Samhita, Ashtanga Sangrah and Ashtanga can prolong survival or reduce symptoms but may cause Hridaya were consulted as research references, to know severe adverse effects and also prevents the patient from the line of treatment in ancient system Ayurveda. engaging in meaningful life. Today even experts believe Evidence based resources as journals, books, and data that the appropriate role of chemotherapy in the end of based information from various search engines were life is a complex issue. Thus the role of palliative care is referred for recent information. Critical analysis of very important in such a case during chemotherapy and available literature was done. radiotherapy. Actually while treating the patient the DISCUSSION physician should aim to improve patient’s quality of life Modern view of cancer and relieve symptoms and increase the survival by many folds. Habits like smoking and alcohol will lead to [10] increase in the chronic disease especially as cancer. Cancer insight of Ayurveda Tobacco consumption in term of chewing tobacco or Classical text of Ayurveda define the causes of cancer as smoking will account for 50% of all cancers. Clear factor fallow. causing cancer are processed meat, dairy products and  Aahar (food) - Ati katu ras (pungent), Ati amla ras alcohol. Obesity is a clear risk factor for cancer.[7] (sour), Ati mudhur ras (sweet), Ati lavan ras (salty), Chemotherapy and radiotherapy are highly toxic and Ati ushna (hot), Ati sheeta (cold), Ruksha aahar (dry), both damage adjacent healthy cells. Side effect may be Virudhaashan, Adhyashan, Paryushitaahar. acute or late. Nausea, vomiting, diarrhea, alopesia,  Vihar (daily routine) - Vega vidharan (suppression of mucositis, constipation are mentioned as side effects of urges), Diwaswap (day sleep), Ratrijagran (night chemotherapy. Fatigue, anorexia, nausea, vomiting, sleep awaiking), Vyavasaya (occupation). disturbance, alteration in taste, headache, constipation,  Manas (mental) - Mansik santap (tension), Krodha dry skin are enlisted as side effect of Radiotherapy. Late (anger). By consuming all above Hetu Vitiation of complication includes pharyngitis, esophagitis, laryngitis, Tridosha occurs which lead to Jatharagnimandya and persistant dysphagia, fatigue, hepatotoxicity, infertility.[8] Aamotpatti. This Apachit dhatu aam vitiates the Sometime death may occur due to other Dhatu of body and developed the Arbuda.[11]

AYUSHDHARA | November - December 2015 | Vol 2 | Issue 6 429 Kiran Tawalare et al. Ayurveda Improve Quality of Life in Cancer Aahar (food) - The diet plays special and importance in the person, this state is known as yoga by the expert. role in country like India. We had a predominantly plant In India, approximately 56% of cancer patient took based diet. Indian spices not only add the test aroma, recourse to alternative therapies, among these, yoga was flavor but also consumption of spices provides infinite the third most commonly accepted therapy.[24] Emotional health benefits. Systematic research revealed that suppression become mandatory to carry on with life this following spices posses anti cancerous activity. result in chronic imbalance that disturb homeostasis and 1. Kesar (Crocus sativa) - crocetin a carotenoid has anti promote cancer. It can be used for management of side tumor activity.[12] effect, reduction of cost involved, avoid poor quality of 2. Haridra (Cuecuma longa) - curcumin has life, minimize psychological ill health and reduce proapoptotic and anti proliferative actions.[13] recurrences. Aasan, pranayam, meditation etc. are techniques to help the patient arrive at an internal 3. Lavanga (Syzygium aromaticum) - eugenol.[14] mastery over the mind and Prana that help in correcting 4. Lashuna (Allium sativum) - organosulphur the imbalance.[25] A physical level of these practices that compounds has cancer preventive and tumor include Yogik kriya, the cleansing of body, endotoxins [15] suppressive effect. (Aama) and molecular toxins such as free radical levels 5. Methika (Trigonella foenum) - seed of fenugreek are corrects the life style. All practice in yoga allows the cytotoxic in vitro to cancer cells.[16] mind to rest in a state of inner wakeful sleep. A single 6. Sunthi (Zinzibar officinnale) - extract has significant positive thought has the ability to reverse the imbalance growth inhibitory effects in a spectrum of prostate at all levels.[26] Deep inspiration breath prove beneficial cancer cells.[17] in locally advanced breast cancer. [27] 7. Kali marich (Piper nigrum) - piperine found to Panchkarma Therapy - It is also called as process of antioxidant, anti inflammatory and anti cancer cleansing, detoxification. Incompatibility in food, life activities.[18] style, chemo-radio therapy and hormonal therapy result 8. Jatiphala (Myristica fragrans) - methanol extracts are in vitiation of Doshas mainly Pitta dosha in the body, such effective in human leukemia T cells.[19] excessive vitiation of Doshas have to be eliminated from Vihar (daily routine) - It contains Dincharya, the body through the procedures like Vaman, Virechan, Rutucharya and Aachar rasayan. Basti, Nasya and Raktamokshana. Thus Panchkarma also minimize the future risk of cancer by purifying the body 1. Dincharya - Aacharya explained how to follow a good system and it can also use as preventive majors to conduct in a whole day. Brahma Muhurte utthithate individuals with family history of cancer. Sesame oil (early morning wake up before sun rise), Anjan which is used in Panchkarma for massage and Basti has karma, Dhoompan, Natsya, Dantavishodhan, Gandush also been shown to have anti neoplastic properties.[28] and Kawal, Karna tarpan, Sneha abhyanga, Sharir parimarjan.[20] Shaman - Method of controlling, preventing and curing the disease by using medicines, foods and activities is 2. Rutucharya or conduct according to season - there called as Sansaman.[29] It is also called as palliative are six Rutu according to Ayurveda i.e. Shishir, treatment. Cancer patients face side effects of chemo Vasant, Grishma, Varsha, Sharad, Hemant.[21] therapy, radiotherapy hormonal therapy, generally 3. Adharaniya vega (non suppression of urges) - for resembling to Pittapradhan tridosha prakopa. Hence being healthy one should not suppress the natural Shaman chikitsa play an important role, Triphala, urges there are thirteen non suppressive urges.[22] Ashwagandha etc. are main Shamak dravya. Recent 4. Aachar rasayan - The concept of Rasayan has been invention has proved that it has antioxidant property, it evolved for improving the quality of life through enhances the immune function, it also increased the various specialized procedures. Rasayan deals with reactive oxygen species in breast cancer cells. all angles of health i.e. physical, mental, social, Aswagendha has been shown to exhibit antioxidant effect spiritual aspect. Aachar rasayan is Adravyabhoot in the brain and have a tranquilizing effect on the central type of Rasayan in which no pharmaceutical measure nervous system in animals. Root of the plant have is taken under consideration. It increases immunity cytotoxic properties against H- 460 also Ashwagandha of body and make mind fresh which is an essential increase cytoxic T Lymphocyte production.[30] The Prime factor for healthy life. With the knowledge of medicine used in cancer treatment are as Bacopa literature one will restrict himself from monniera, Glycyrrhiza glabra, Ocimum sanctum, Pragyaparadha which is a factor among three major Terminalia chebula Asparagus racemosa, Hydrocotyle contributors, for ill health. Some factors of Aachar asiatica, Nordostachys jatamansi, Elettaria cardamomum, rasayana given in text are free from anger, free from Tribulus terrestris.[31] A report of ACTREC (Advanced alcohol consumption, cleanliness, balance sleep, Centre for Treatment Research and Education in Cancer) spiritualism etc.[23] and CCRAS (The Central Council for Research in Yoga - Happiness and misery arise due to conduct of the Ayurvedic Sciences) anti cancer and antitumor Atma (soul), Indriya (sense organs), Mana (mind) and properties of indigenous medicinal plants extract in ethyl Indriya vishaya (sense objects) but when the mind is alcohol and tested to measure their cytotoxicity against steadily concentrated to the self, both cease to exist due tumor Arka (Calatropis procera) and Bhallataka to non initiation and a super natural power comes forth (Semicarpus anacardium) appeared to have greatest

AYUSHDHARA | November - December 2015 | Vol 2 | Issue 6 430 AYUSHDHARA, 2015;2(6):428-432 cytostatic activity. Other herbal plants having anti CONCLUSION cancerous activity are - Plumbago rosea, Withania In case of cancer, etiology, prognosis and line of somnifera, Semicarpus anacardium, Achyranthes aspera, treatment is not satisfactory. Side effects of Saraca ashoka, Hemidesmus indicus, Pandanus chemotherapy occur in patients of cancer and quality of odoratissimus, Tinospora cordifolia, Commiphora life decreases. Hence accepting the limitation of all mukul.[32] pathies, integrated approach to fight against cancer Satvavjaya treatment - It is also called as Aaswasan should be adapted. Application of principles of Ayurveda chikitsa. It is used as psychological therapy. Patient with as Aahar (food), Vihar (routine), Yoga, Panchakarma, cancer have to face treatment like chemotherapy and Samshaman, Satwavajaya, Rasayan therapy, Satvrutta, radiotherapy. 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Cite this article as: Kiran Tawalare, Ganesh Hedaoo, Snehvibha Mishra, Ravindra Dhimdhime, Gopal Sharma, Kalpana Tawalare. Need of Integrated Approach Against Cancer to Improve Quality of Life Insight of Ayurveda. AYUSHDHARA, 2015;2(6):428-432. Source of support: Nil, Conflict of interest: None Declared

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